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Statins with shorter half-lives are more effective when taken in the evening, so their peak effect occurs when the body's natural cholesterol production is at its highest. A recent meta-analysis suggested that statins with longer half-lives, including atorvastatin, may also be more effective at lowering LDL cholesterol if taken in the evening. [38]
Fibrates may decrease LDL, though generally to a lesser degree than statins. Similar to statins, the risk of muscle damage exists. Nicotinic acid, like fibrates, is also well suited for lowering triglycerides by 20–50%. It may also lower LDL by 5–25% and increase HDL by 15–35%. Niacin may cause hyperglycemia and may also cause liver damage.
The most important adverse side effects are muscle problems, an increased risk of diabetes mellitus, and increased liver enzymes in the blood due to liver damage. [5] [65] Over 5 years of treatment statins result in 75 cases of diabetes, 7.5 cases of bleeding stroke, and 5 cases of muscle damage per 10,000 people treated. [34]
While muscle pain (myalgia) is seen in 9-20% of patients treated with statins, it typically occurs in the first month of treatment. SAAM has a later onset, occurring years after uncomplicated statin use. In some cases even after statins have been discontinued for several years. [5]
Includes factors that can increase the risk of heart disease, such as kidney disease, obesity and a marker of poor blood sugar control (hemoglobin A1C). Calculates risk separately for men and women.
1. What is osteoporosis? Osteoporosis is a disease of the bones. People with osteoporosis have bones that are weak and break easily. Osteoporosis is called a “silent” disease.